Provider First Line Business Practice Location Address:
1430 ROUTE 286 HWY E
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
INDIANA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15701-1459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-349-1420
Provider Business Practice Location Address Fax Number:
724-349-6552
Provider Enumeration Date:
03/05/2007